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Home My WebLink About426767 HOFF CONSTRUCTION - INSURANCE CERTIFICATE (4)Client#: 247411 HOFC01 ACORD. CERTIFICATE OF LIABILITY INSURANCE D4/01/2013"""' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 / I 970356-0123 NAME: Sandy Schlfferns PHONE g70 266-7107 EA, 970 506-6845 A/C No Ext : A/C, No ADDRIESS: sschifferns@floodpeterson.com CUSTOMER IDk: HOFC01 INSURER(S) AFFORDING COVERAGE NAIC a INSURED GL Hoff Company Elba Hoff Construction INSURER A. Bituminous Insurance INSURERB: Pinnacol Assurance P.O. Box 7448 INSURER C : Loveland, CO 80537 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LR T TYPE OF INSURANCE D BR POLICY NUMBER MWDDNYYY EXP MWDD NYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X PDDed:2,000 CLP3585801 04/01/2013 04/01/2014 EACHOCCURRENCE $1 000000 DAMAGE TO FEN PREMISES Ea occurrence) $300000 MED EXP (Anyone person) $10DDD PERSONAL & ADV INJURY $1000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC IFCT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP3585478 04/01/2013 04/0112014 COMB I NED SINGLE LIMIT (Ea accident $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP2802433 104/01/2013 04/01/201 EACH OCCURRENCE $1 000000 AGGREGATE $1 DDD DDD DEDUCTIBLE RETENTION S 10,000 S X S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRIETOWPARTNEWEXECUTIVEY OFFICER/MEMBER EXCLUDED? (Mandatary in NH) It yes, describe under DESCRIPTION OF OPERATIONS below WA 2242590 04/01/2013 04/01/2014 WCSTATLL I OTH- X I E.L. EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1,000000 E.L. DISEASE - POLICY LIMIT $1 DDD DDD DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is named as additional insured as their interest may appear in regards to the operations of the named insured. (Excluding Workers' Compensation) Bond Renewal City of Fort Collins Bond Renewal P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD Client 11 24740 HOFCOI ACORD,. CERTIFICATE OF LIABILITY INSURANCE D TE m 0 3YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 NAME: Sandy SChlfferns PHONE 970 266-7107 FAX 970 506-6845 A/C No Exl: A/C, No: ADDRESS: sschifferns@floodpeterson.com 'PRODucER HOFC01 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC# INSURED GL Hoff Company dba Hoff Construction INSURER A: Bituminous Insurance INSURER B: Pinnacol Assurance P.O. Box 7448 INSURER C Loveland, CO 80537 INSURER D : INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE ISH1DD AND POLICY NUMBER MM/DD/YYYY POLICY EFF POLICYEXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR X PD Ded:2,000 CLP3585801 04/01/2013 04/01/2014 EACHOCCURRENCE $1 000000 PREMISES Ea ccu ence $300000 MED EXP (Any one person) $1 O 000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOG PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP3585478 04/01/2013 04/01/2014 COMBINED SINGLE LIMIT (Ea accident) $1 000.000 X BODILY INJURY (Per person) S BODILY INJURY (Per accident) 5 PROPERTY DAMAGE (Per accident) $ X X S A X UMBRELLA LIAB EXCESS LIAR IV OCCUR CLAIMS -MADE CUP2802433 I04/01/2013 04/01/2014 EACH OCCURRENCE $1 000000 AGGREGATE $1 00O 000 DEDUCTIBLE RETENTION 10,000 $ X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNEWEXECUTIVE Y❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under OE SCRIPTION OF OPERATIONS below WA 2242590 04/01/2013 I 04/01/2014 OTH- X WC STATU- ER E.L. EACH ACCIDENT $1 DUD 000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 I E.L. OISEASE-POLICY LIMIT $1 ODUU00 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUIC11n Permits and Inspection Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 P ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 ) AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S775322/M775316 SIR